@Article{ecn.2009.0185,
AUTHOR = {Marta Suárez-Santamaría, Francisco Santolaria, Alina Pérez-Ramírez, María-Remedios Alemán-Valls, Antonio Martínez-Riera, Emilio González-Reimers, María-José de la Vega, Antonio Milena},
TITLE = {Prognostic value of inflammatory markers (notably cytokines and procalcitonin), nutritional assessment, and organ function in patients with sepsis},
JOURNAL = {European Cytokine Network},
VOLUME = {21},
YEAR = {2010},
NUMBER = {1},
PAGES = {19--26},
URL = {http://www.techscience.com/ECN/v21n1/65875},
ISSN = {1952-4005},
ABSTRACT = {Objective. Procalcitonin is useful for the diagnosis of sepsis, but its prognostic value regarding
mortality is unclear. Our objective was to determine the prognostic value of procalcitonin determined at the
onset of sepsis, and to compare it with other markers of inflammatory response, malnutrition and organ dys-function
data. Methods. We studied 253 hospitalized patients (146 men, 107 women) with a median age of 65
years. Sepsis was defined as infection, and at least two SIRS criteria. We assessed co-morbidities, nutritional
status, bacteremia, procalcitonin and other inflammatory markers (PCR, TNF-α, IL6, TREM-1, IL-10, IL-1ra,
CD14 and LBP), and organ function using the SOFA score. Mortality was assessed at 28 days after onset of
sepsis. Results. At day 28, 49 (19%) patients had died. Inflammatory markers showed only moderate predictive
value for mortality, with IL-10 and IL-6 being the best predictors. Mortality was mainly related to organ
dysfunction indicators (SOFA and Glasgow scores), serum lactate, ferritin and LDH levels, and to nutritional
data such as subjective assessment, handgrip strength and serum transferrin levels. The most frequent location
of sepsis was the lung, with 140 cases (55%), which showed more comorbidity, worse nutritional status, less
frequent bacteremia and lower inflammatory response. When the analysis was limited to patients with non-pulmonary
sepsis, organ dysfunction, nutritional status and inflammatory markers showed the best prognostic
value. Of the inflammatory markers, procalcitonin showed only moderate predictive value; however it showed
the highest correlation with bacteremia and the ability to discriminate non-complicated sepsis from severe
forms. Conclusion. Procalcitonin only showed moderate predictive value for sepsis-related mortality, being sur-passed
by organ dysfunction, nutritional status, IL-10 and IL-6. However, it proved useful to discriminate
between non-complicated and severe forms of sepsis.},
DOI = {10.1684/ecn.2009.0185}
}